The Money Mustache Community
Learning, Sharing, and Teaching => Ask a Mustachian => Topic started by: ves on February 21, 2015, 06:59:24 AM
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Hi,
My Employer Provide two plan
1.HDHP with HSA ( no Contribution from Employer)
2.a plus plan(ppo).
HDHP
Deductible : 1500 EE/ 3000 Family
Coinsurance : covers 80% after deductible
Outofpocket Max : 2500EE/5000EE+1 or more
Pharmacy : included in medical deductibles. after deductible 10/20/35 copay for generic/prefered/non prefered
Plus Plan :
Deductible : 600 EE/ 1800EE+1 or more
Copay : 20/35/50 for PCP/Specialist/no designated specialist
Coinsurance : covers 80% after deductible
Out of pocket Max : 1750 EE/ 5250 EE+1 or more
Pharmacy : No deductibles, 20 / 40/75 copay, Out of pocket Max : $4,850 EE Only $7,950 EE+1 or more
Annual Premium For HDHP : $2106.. PLUS : $4396
Currently Open enrollment running, plan begins April 2015.
We are expecting pregnancy in august 2015.
I am running numbers, i found HDHP is beneficial than Plus PPO..
Since the charges for Vaginal Delivery Uncomplicated 15900..
Running Numbers ended like HDHP 5000 -750(5000 towards Hsa tax deductible)+ 2106(premium) =6356
PPO : 1750 (opm for EE) +4396(premium) +unknown pharmacy cost+coinsurance for family till 5250 = 6119
Since HDHP higher ,but i feel it may beneficial..
Am I missing something ? help is highly appreciated.
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Can any mustachian throw some light on this? help is highly appreciated
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Running Numbers ended like HDHP 5000 -750(5000 towards Hsa tax deductible)+ 2106(premium) =6356
PPO : 1750 (opm for EE) +4396(premium) +unknown pharmacy cost+coinsurance for family till 5250 = 6119
Since HDHP higher ,but i feel it may beneficial..
Am I missing something ? help is highly appreciated.
You may be making the correct comparison, but it is not clear from this post.
Try putting the numbers in a spreadsheet with rows describing the different cost categories, then one column for PPO and another for HDHP. Seeing it this way would help us (and more importantly, you) understand if the comparison is correct.
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I'm a little confused why did you take OOP cost for EE for the plus plan which is $1750 but not for the HDHP? If you did the same for the HDHP to compare apples to apples the OOP max cost for EE for the HDHP is only $2500 so total cost for HDHP is $2500 - ( whatever tax deduction you get) + $2106 (premium) should be less than the plus plan.
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Here i attach screenshot
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Thanks for the reply MDM & gluskp.
dear gluskp, i understand in the HDHP the family deductible met first, then only the insurance part kicks in
But in PPO, Individual Deductible met once, then the insurance part kicks for the individual before family deductible meet
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Here i attach screenshot
Screenshots of the sign-up site are nice, but even better would be for you to convert those to a spreadsheet showing the likely costs for your particular family.
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I understood MDM.
https://docs.google.com/spreadsheet/ccc?key=0AvvZYezXpO9WdC1hdFMzNk0xZXd1dy1IRERRNmNCcEE#gid=0 (https://docs.google.com/spreadsheet/ccc?key=0AvvZYezXpO9WdC1hdFMzNk0xZXd1dy1IRERRNmNCcEE#gid=0)
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My Main doubt is,
Once baby born , Family out of pocket Maximum counted or Individual (Mother's) Out of Pocket Maximum Considered?
Thats make confusing and $1000 more in HDHP plan
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https://docs.google.com/spreadsheet/ccc?key=0AvvZYezXpO9WdC1hdFMzNk0xZXd1dy1IRERRNmNCcEE#gid=0 (https://docs.google.com/spreadsheet/ccc?key=0AvvZYezXpO9WdC1hdFMzNk0xZXd1dy1IRERRNmNCcEE#gid=0)
That spreadsheet is password protected.
You could also cut & paste from the spreadsheet into a post. If the formatting doesn't work well with a simple cut & paste, see http://forum.mrmoneymustache.com/forum-information-faqs/how-to-formatting-a-table or http://forum.mrmoneymustache.com/forum-information-faqs/how-to-simple-step-by-step-guide-for-posting-formatted-table
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blue
| | HDHP | | | PLUS | | |
| Deductible | | $3,000.00 | | | $600.00 | |
| Max out-of-pocket | | $5,000.00 | | | 1750 | |
| Coinsurance % | | 20% | | | 20% | |
| Monthly premium | | $176.00 | | | $367.00 | |
| Annual premium | | $2,112.00 | | | $4,404.00 | |
| | | | | | | |
| If expenses are… | $0.00 | $0.00 | $15,950.00 | $0.00 | $0.00 | $15,950.00 |
| Deductible cost | $0.00 | $0.00 | $3,000.00 | $0.00 | $0.00 | $600.00 |
| Covered amount | $0.00 | $0.00 | $12,950.00 | $0.00 | $0.00 | $15,350.00 |
| Coinsurance cost | $0.00 | $0.00 | $2,000.00 | $0.00 | $0.00 | $1,150.00 |
| Out-of-pocket costs | $0.00 | $0.00 | $5,000.00 | $0.00 | $0.00 | $1,750.00 |
| | | | | | | |
| TOTAL COST | $2,112.00 | $2,112.00 | $7,112.00 | $4,404.00 | $4,404.00 | $6,154.00 |
| | | | | | | |
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Dear MDM,
Thanks for the reply.. i can convert table to some smf code as per the post but it looks like above :-( anyhow i publicly share the spreadsheet in google spreadsheet here.
https://docs.google.com/spreadsheet/ccc?key=0AvvZYezXpO9WdC1hdFMzNk0xZXd1dy1IRERRNmNCcEE&usp=sharing
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and the tricky part is,
in plus plan out of pocket for individual is 1750
Family deductible 1800
Family out of pocket meximum is $5250.
Can any Dad Mustachian help, how the hospital billed..seperate for mother and new born or combined both